We’ve had many clients asking for details about the forthcoming Federal Healthcare Reform (also known as HCR) and its effect on them or their businesses. Until this past week, we’ve not had many concrete details. And rules, regulations and procedures are ever-changing. Last Thursday, we were told by BCBSNC that the actual HCR law is more than 2,000 pages and the changes and updates received thus far are 30,000-plus pages. So as you can see, this continues be a developing issue until, at least, the Open Enrollment Period (OEP)begins on October 1, 2013.
Let’s talk about some of the basics of HCR:
Federal Healthcare Reform is called “ACA,” the Affordable Care Act, “PPACA,” Patient Protection and Affordable Care Act or “Obamacare”. The ACA was signed into law on March 23, 2010 by President Barack Obama. The intent of the law is to put “consumers back in charge of their health care. Under the law, a new “Patient’s Bill of Rights” gives the American people the stability and flexibility they need to make informed choices about their health.” (http://www.hhs.gov/healthcare/rights/index.html)
The ACA requires that 10 Essential Health Benefits (EHBs) be included in each plan. Some are new and some are expanded from previously implemented benefits. Some of the benefits included in the EHBs are:
- Coverage for hospitalization, emergency and laboratory services, without exclusion or limitation for pre-existing conditions;
- Preventive and wellness services for all ages, chronic disease management and rehabilitative care;
- Increased mental health and substance abuse treatment;
- Pediatric dental and vision care
Plans are defined by 4 levels of coverage – Platinum, Gold, Silver and Bronze, often referred to as the “Metallics.” Each level will have several deductible, copay, coinsurance and out-of-pocket maximum plan choices.
You can purchase your health insurance in or out of the “Exchange” or Health Insurance Marketplace. But the only way to apply for a subsidy or lower cost premiums is to apply through the Exchange.
Our agents will be able to assist you with plan recommendations for you and your family. The cost to have an agent represent you is exactly the same as trying to navigate the Marketplace on your own.
We have the benefit of BCBSNC’s Blue Map, which will enable us to compare your current health insurance plan and premiums against the ACA plans and rates. This will aid us helping you make an informed decision you’ll feel good about.
If you currently have a Grandfathered health insurance plan, you will be able to continue your Grandfathered plan until your 2014 renewal. At the end of 2014, all Grandfathering will become obsolete. At your 2014 renewal, you will be automatically rolled into one of the Metallic plans.
Please give us a call to help you find the very best health insurance option for you, your family &/or your business. That’s what we are here for. And we’re always here for you!
June 30, 2013
Michele Fogle Sizemore
